More high school students than ever are coming out, but their despair remains acute

As teen depression and suicide have risen generally, the crisis is still greater among gay, bisexual and questioning youth.

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The proportion of high school students who identify as a sexual minority — lesbian, gay, bisexual, or questioning (LGBQ) — doubled in the past several years, according to a new study published Monday.

Yet those greater numbers have not necessarily meant they have found greater acceptance or peace. The study, based on data from a federal survey, found that those teens attempted suicide at a rate nearly four times higher than their heterosexual peers.

The research, published in the journal Pediatrics, was based on data from the Youth Risk Behavioral Surveillance Survey from 2009 to 2017. The findings were based on survey information from Delaware, Illinois, Massachusetts, Maine, North Dakota, and Rhode Island, the only six states that continuously collected sexual orientation data for all those years.

These new findings, particularly the disproportionate rate of suicide attempts, dramatically point out the need for increased efforts to assist and support these young people, according to the researchers.

“Large disparities in suicide attempts persisted even as the percent of students identifying as LGBQ increased. In 2017, more than 20% of LGBQ teens reported attempting suicide in the past year,” said lead study author Julia Raifman, an assistant professor with Boston University’s School of Public Health.

“It’s critical that health and educational institutions have policies and programs in place to protect and improve LGBQ health, such as medical school curricula and high school health curricula that are inclusive of sexual minority health,” Raifman said.

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According to the study, 14.3% of U.S. teens identified as a sexual minority in 2017, compared with 7.3% in 2009. Adolescent girls in 2017 were twice as likely as boys to identify as a sexual minority.

The research also found that many more high schoolers are engaging in or at least experimenting with same-sex sexual contact. Their numbers increased from 7.7% of teens in 2009 to a little over 13% in 2017.

The sexual contact numbers were based on data from Delaware, Connecticut, Illinois and Rhode Island, the four states that continuously collected that information from 2009 to 2017.

As troubling as the high rate of suicide attempts for sexual minority teenagers compared to heterosexual kids is, the rate at the beginning of the study period was even worse.

In 2017, a little over 20% of the high schoolers who identified as sexual minorities reported attempting suicide, compared to 26.7% in 2009. The reported suicide attempt rate for heterosexual kids was about 6% for both those years.

“Our paper indicates that an increasing number of teenagers are identifying as LGBQ and will be affected by anti-LGBQ policies that may elevate these already very high rates of suicide attempts,” Raifman said.

Raifman said previous research she was involved in show a correlation between public policies and LGBQ suicide attempts and mental health.

In one 2017 study, Raifman and colleagues found a 7% reduction in suicide attempts in high school students, particularly those identified as sexual minorities, in states that allowed same-sex marriage. A 2018 study led by Raifman found increased mental health distress among sexual minority individuals in states where there had been publicized cases of anti-gay discrimination.

Suicide is the second leading cause of death for young people ages 10 to 24.

In addition to Boston University, the study authors include researchers from Boston Children’s Hospital, Harvard Medical School and the School of Public Health, Johns Hopkins’ School of Medicine, Brown University’s School of Public Health and medical school, along with other hospitals.